About: Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology

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About: Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology
Creator	Chung, Kevin Vittinghoff, Eric Kelly, John Ambris, Herman Aziz, Shazia Baxi, Sanjiv Dimitrov, Vihren Health, Nyc Jensen, Deanna Lincoln, Hospitals Menon, Vidya Perez Gutierrez, Victor Shelhamer, Mehdi Solari, Ian Steele, William Wesson, Paul
Source	Medline; PMC
abstract	BACKGROUND: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory distress syndrome (ARDS) but it is unknown whether prone positioning improves outcomes in mechanically ventilated patients with moderate to severe ARDS due to COVID-19.METHODS: A cohort study at a New York City hospital at the peak of the early pandemic in the United States, under crisis conditions. The aim was to determine the benefit of prone positioning in mechanically ventilated patients with ARDS due to COVID-19. The primary outcome was in-hospital death. Secondary outcomes included changes in physiologic parameters. Fine-Gray competing risks models with stabilized inverse probability treatment weighting (sIPTW) were used to determine the effect of prone positioning on outcomes. In addition, linear mixed effects models (LMM) were used to assess changes in physiology with prone positioning.RESULTS: Out of 335 participants who were intubated and mechanically ventilated, 62 underwent prone positioning, 199 met prone positioning criteria and served as controls and 74 were excluded. The intervention and control groups were similar at baseline. In multivariate-adjusted competing risks models with sIPTW, prone positioning was significantly associated with reduced mortality (SHR 0.61, 95% CI 0.46-0.80, P < 0.005). Using LMM to evaluate the impact of positioning maneuvers on physiological parameters, the oxygenation-saturation index was significantly improved during days 1-3 ( P < 0.01) whereas oxygenation-saturation index (OSI), oxygenation-index (OI) and arterial oxygen partial pressure to fractional inspired oxygen (P (a) O (2) :FiO (2) ) were significantly improved during days 4-7 ( P < 0.05 for all). CONCLUSIONS: Prone positioning in patients with moderate to severe ARDS due to COVID-19 is associated with reduced mortality and improved physiologic parameters. One in-hospital death could be averted for every eight patients treated. Replicating results and scaling the intervention are important, but prone positioning may represented an additional therapeutic option in patients with ARDS due to COVID-19.
has issue date	2020-08-17(xsd:dateTime)
bibo:doi	10.21203/rs.3.rs-56281/v1
bibo:pmid	32839769
has license	cc-by
sha1sum (hex)	d1f5250284199a6a22a59d1e75672636e8c4de12
schema:url	https://doi.org/10.21203/rs.3.rs-56281/v1
resource representing a document's title	Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology
has PubMed Central identifier	PMC7444300
has PubMed identifier	32839769
schema:publication	Res Sq
resource representing a document's body	covid:d1f5250284199a6a22a59d1e75672636e8c4de12#body_text
is schema:about of	named entity 'IMPROVES' named entity 'Coronavirus disease 2019' named entity 'COVID-19' named entity 'hypoxemic' named entity 'registered nurse' named entity 'follow-up' named entity 'COVID-19' named entity 'Stata' named entity 'healthcare worker' named entity 'cumulative incidence' named entity 'respiratory therapist' named entity 'COVID-19' named entity 'ARDS' named entity 'demographic' named entity 'intubation' named entity 'intensive care units' named entity 'mechanical ventilation' named entity 'physiological parameters' named entity 'intubation' named entity 'United States' named entity 'mechanically ventilated' named entity 'ARDS' named entity 'chronic health' named entity 'mm Hg' named entity 'South Bronx' named entity 'extracorporeal membrane oxygenation' named entity 'death rates' named entity 'physiology' named entity 'control group' named entity 'high volume' named entity 'March 25' named entity 'Diabetes' named entity 'NYC' named entity 'intensive care unit' named entity 'critically ill' named entity 'mechanical ventilation' named entity 'New York City' named entity '0.01' named entity 'ARDS' named entity 'mechanical ventilation' named entity 'intensive care' named entity 'absolute risk' named entity 'supine position' named entity 'ICU' named entity 'COVID-19' named entity 'ARDS' named entity 'descriptive statistics' named entity 'College Station, TX' named entity 'LMMs' named entity 'quality control' named entity 'degree of agreement' named entity 'ect' named entity 'perfusion' named entity 'lung' named entity 'cohort design' named entity 'Bronx' named entity 'cumulative incidence' named entity 'clinical presentation' named entity 'intubation' named entity 'ARDS' named entity 'COVID-19' named entity 'FiO2' named entity 'canula' named entity 'COVID-19 pandemic' named entity 'respiratory failure' named entity 'BMI'

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